Implant problem 5 years on.

[Joe1947]

I experienced success and satisfaction with an AMS inflatable device after trying tablets, pump and injections.
I am 69 and had prostate cancer surgery six years ago.
One day in August I felt a jolt/shock and pain similar to what I had with the injections.
Normally I used 40 pumps for a full erection but now even 20 gives me mild pain.
With around 35 pumps for a full erection, the pain is unbearable after 10 minutes.
There is no pain when penis is less than half inflated. I always kept penis partially pumped.

My GP and Urologist can see nothing wrong and found mechanics working fine leaving only option may be possibly a low grade infection?
I am waiting six months to see how it goes. My Urologist commented that there is high risk of infection for replacing an implant so I am bit nervous about that.

Really appreciate any help, suggestions or your experiences.

[Lenny1965]

How long have you had the current pump?

[Lost Sheep]

Which model implant? One model had a higher incident of "blowout" failure.

Lost Sheep

Edit; AMS Ultrex is one model. Now off the market, I believe.
Look up a paper titled "Cylinder Sizing: Less is More" by Montague and Angermeier for one mention of the type of failure we suspect.

[Bionic_by_AMS]

Joe,

I felt a jolt/shock and pain similar to what I had with the injections

Did this occur when erect? ... Sounds like a cylinder failure ... where a partial tear in the outer covering allows the inner lining to pop out and creates a bubble. The more you pump ... the bigger the bubble ... you get the idea.

only option may be possibly a low grade infection

Wow! ... based on your description = jolt/shock and pain ... = an infection ... very doubtful

My Urologist commented that there is high risk of infection for replacing an implant

Sounds like your URO doesn't want to replace the Implant and is giving your excuses. I would go see a different URO and get another opinion.

[Joe1947]

Thanks to Lenny1965, Lost Sheep, and Bionic by AMS.

AMS700ms was fitted 2011.
Urologist who did my op moved to the other side of Australia but the Uro who took over his patients has my records.
He is a really easy to talk to guy but he had not seen this happen before.

Yes when I felt the snap it was erect.

When you mention “blowout” or “cylinder failure” would there not be some evidence?
My pump is still pumping, and there is no sign of any bulge or irregularity.

[Lost Sheep]

Thanks to Lenny1965, Lost Sheep, and Bionic by AMS.

AMS700ms was fitted 2011.
Urologist who did my op moved to the other side of Australia but the Uro who took over his patients has my records.
He is a really easy to talk to guy but he had not seen this happen before.

Yes when I felt the snap it was erect.

When you mention “blowout” or “cylinder failure” would there not be some evidence?
My pump is still pumping, and there is no sign of any bulge or irregularity.

You are welcome.

Did you find the article I mentioned in my earlier post? Find the full article and scroll down. You will find a picture os a cylinder with a prominent bulge where a weak point stretched out.

Such a cylinder"aneurism" could cause your issues. No bulge to your penis because pain stops you from pumping up enough to be evident. But you might be able to feel the bulge, I suspect. In the meantime your own tunica albugenea provides enough support for a marginsl erection.

Eventually, the weak spot will blow out or leak and the saline in the implant will wind up in your penis, be absorbed into your body and the reservoir, pump and cylinders will no longer work at all.

Get to someone who can diagnose this and begin fixing it as soon as you possibly can.

I am not a medical professional, but have done a bit of research and think my guess (and the suggestions of the other respondents) are correct.

Lost Sheep

[Bionic_by_AMS]

Joe,
If the "bubble" is on the inside ... you wouldn't see it ... but you feel it ... right?

[Joe1947]

It’s sounding very feasible that the snap could be the tube wall failing!
I noticed the pump operates a lot easier since it happened.
The Uro said I was a bit loose at the base too.

Would an MRI pick up the fault? I discussed xrays, MRI and Uro said it may not show anything (when he found nothing obvious).

I disregarded the article "Cylinder Sizing: Less is More" originally because the pictures were not applicable but when you made me understand more about a “weak spot”, I believe this is what happened and I will need a replacement.

I get the feeling implants are commercialised with Uro specialising in one brand only - do you think?
How much more complicated is the procedure to replace the device than the original surgery and is infection a higher risk second time around?
How to find the right surgeon?

Thanks to the forum for giving such understandable, relevant and knowledgeable info.

[Bionic_by_AMS]

Joe,
If you are not comfortable with your URO to replace your Implant ... look else where. The "high volume" URO's are your best bet ... but be aware you will need to cover all your travel expenses.

I assume that your Insurance company paid for your Implant ... so they should cover the replacement ...

Yes, most of the high volume URO's have preferences on the brand they install ... (they call it a discount ... we call it a kickback). One brand does not have cylinder failure rates greater than the other.

The infection rate goes up when these local "old school" URO's want to remove the Implant ... then wait, then schedule another operation. Most of the high volume URO's will remove and replace all in one shot.

Good Luck on finding a satisfactory solution ...

[jonbaldbg]

Joe,

They say that replacements are easier to deal with than the original surgery. I assume that means that recovery is easier.

My surgeon uses both kinds of implants. He will discuss the options with you and do what you choose, but he will guide you based on your specific situation.

He can't take kickbacks because he's a part of a University Hospital.

If you want to see a video about one brand vs. the other, go here:

https://www.youtube.com/watch?v=8PPId-OVzag